Health Care Systems

OHE’s Koonal Shah is a co-investigator in research intended to define public preferences about allocating health care resources to patients who are at the end of life. In late March, OHE hosted a Lunchtime Seminar that examined both the approach and the results of research to date.

Medicines account for less than 10% of total NHS expenditure in the UK. Because spending on medicines is easy to separate out, however, this sector continues to come under particular scrutiny in efforts to manage costs. Forecasting spending on medicines can be useful in planning NHS resource allocation.

OHE’s Dr Jorge Mestre-Ferrandiz is a visiting lecturer in the Department of Economics at City University London. As part of his 2013 activities, he recently gave a comprehensive lecture on the economics of the market for medicines in the UK. His presentation covers the key issues, from drug development through health technology assessment and market access.

OHE’s Jon Sussex has studied and written extensively on competition in the NHS. He was a member of the OHE Commission on Competition in the NHS and rapporteur of its 2012 report. We asked him to comment on the latest NHS competition regulations. Last week the UK’s coalition government published a revised draft of regulations to govern competition among providers of health care funded by the NHS in England.

19 March: Jon Sussex will be at BioWales 2013 speaking on the health and wider economic benefits of life sciences research. 21 March: Jorge Mestre-Ferrandiz will give his updated annual presentation on the economics of the market for medicines at City College in London. 21/22 March: Nancy Devlin will be in Singapore with EuroQol colleagues. Until 12 April, OHE is accepting applications for a fixed-term position for an economist. Keep up with the latest!

Debates about whether to increase state assistance to the elderly have included concerns that this could reduce the amount of care from such personal caregivers, producing a limited net benefit. In a new research paper released today, OHE’s Sarah Karlsberg Schaffer undertakes a comprehensive analysis based on a “natural experiment”: the introduction of free personal care for the elderly that was implemented in Scotland in 2002, but not elsewhere in the UK.

With Prof Patricia Danzon of the Wharton School, University of Pennsylvania, OHE's Adrian Towse and Jorge Mestre-Ferrandiz have released an important working paper that addresses how to achieve efficient pricing for pharmaceuticals within and across countries.

The proposals from the UK Department of Health (DH) for value based pricing (VBP) include a process whereby higher prices would be granted to medicines that tackle the most burdensome diseases – i.e. those that are most severe or are associated with the greatest unmet need. The DH’s VBP consultation document defines unmet need in terms of the degree to which alternative treatments exist. Little empirical evidence is available, however, on whether the general public supports the use of this particular definition of unmet need as a basis for setting health care priorities. To address this gap in the evidence, Koonal Shah and Nancy Devlin of OHE completed a small exploratory study.

OHE’s research and consulting captures a range of key issues that affect how health care systems are organised and how decisions are made within them. For example, how far to incorporate competition in the provision of NHS-funded health care in England was the focus of the OHE Commission on Competition, which published its report in January 2012.

The OHE has been very active in conceptualising approaches incorporating a broader assessment of the elements of value (often called "value based pricing" or "VBP"), as its publications to date illustrate. During the last quarter of 2012, OHE has been active in discussions of VBP in a variety of forums.


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